Facial nerve management in jugular paraganglioma surgery: a literature review

Odat, Haitham; Sh, Shin; Ma, Odat; Alzoubi, Firas

doi:10.1017/s0022215115003394

Cited by 17 publications

(16 citation statements)

References 33 publications

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“…Our patient got partial FN function improvement from H-B grade V to II at the last follow-up visit. The partial recovery might be due to partial compensation of viable intrinsic arterial plexus of the FN for extrinsic blood supply interruption, as proposed by Odat et al [ 2 ]. However, residual paresis might be explained by prolonged ischemia caused by Onyx or anterior rerouting of the FN itself which deprives the nerve from its extrinsic blood supply.…”

Section: Discussionmentioning

confidence: 94%

“…Jugular paragangliomas (JPs) are slow-growing highly vascular tumors that can cause extensive invasion of the surrounding vital structures [ 1 ]. The gold standard of treatment is complete surgical resection with pre-operative embolization [ 2 ]. When the tumor is inoperable, or the patient is unfit for surgery, radiotherapy or superselective embolization can be alternative primary treatment options [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Facial Nerve Paralysis after Onyx Embolization of a Jugular Paraganglioma: A Case Report with a Long-Term Follow Up

Odat

Alawneh

Al‐Qudah

2018

JCM

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Jugular paragangliomas are slow growing highly vascular tumors arising from jugular paraganglia. The gold standard of treatment is complete surgical resection. Pre-operative embolization of these highly vascular tumors is essential to reduce intra-operative bleeding, allow safe dissection, and decrease operative time and post-operative complications. Onyx (ethylene-vinyl alcohol copolymer) has been widely used as permanent occluding material for vascular tumors of skull base because of its unique physical properties. We present the case of a 33-year-old woman who had left-sided facial nerve paralysis after Onyx embolization of jugular paraganglioma. The tumor was resected on the next day of embolization. The patient was followed up for 30 months with serial imaging studies and facial nerve assessment. The facial verve function improved from House–Brackmann grade V to grade II at the last visit.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Facial Nerve Paralysis after Onyx Embolization of a Jugular Paraganglioma: A Case Report with a Long-Term Follow Up

Odat

Alawneh

Al‐Qudah

2018

JCM

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“…6 Llorente et al 7 found no difference in the surgical exposure attained or the tumor removal possible by mobilizing (rerouting) the temporal part of the facial nerve. Contradicting this are studies of cadaveric dissection by Von Doersten and Jackler, 8 which quote a wider corridor for surgery and lesion removal as well as fewer recurrences 9 on rerouting the facial nerve. It has also been suggested that removal of the bone around the jugular bulb and carotid canal cannot be done satisfactorily without facial nerve rerouting.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Facial Nerve in Lateral and Inferior Mastoid Approaches for Jugular Foramen and Petrous Apex Lesions

Shah

Keshri

Patadia

et al. 2018

IJNS

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Objectives To evaluate the facial nerve in inferior and lateral (transmastoid) approaches to the jugular foramen and/or petrous apex. Design Retrospective study of 11 consecutive patients operated for lesions in the jugular foramen/petrous apex via an inferior or lateral transpetrosal approach. Setting Tertiary care superspecialty referral center. Participants Eleven consecutive patients of jugular foramen/petrous apex lesions operated over a period of 18 months. Main Outcomes Measures Extent of tumor resection, surgical technique used, and recovery of facial nerve function postoperatively. Conclusion Approach to these lesions needs to be tailored to the extent of disease, possible histology and relation to the facial nerve. Meticulous surgery and adequate postoperative care permit a satisfactory recovery of facial nerve function following rerouting procedures. AbstractKeywords ► facial nerve ► jugular foramen ► petrous apex Indian

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“…Non-rerouting approaches permitted the preservation of the facial nerve function in all patients of the present series. A recent review of the literature reported HB grade I-II in 95% of the non-rerouting approaches at the cost of a significant increase of persistence 7 . Consequently, even if conservative approaches could be performed in selected C1 TJPs, the rerouting of the nerve allows an acceptable functional and cosmetic result in 69% of the cases and should be therefore always performed (Table 4.2.2.III).…”

Section: Advancements and Open Issuesmentioning

confidence: 99%

Surgery of the lateral skull base: a 50-year endeavour

Zanoletti¹,

Mazzoni²,

Martini³

et al. 2019

Acta Otorhinolaryngol Ital

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SUMMARY Disregarding the widely used division of skull base into anterior and lateral, since the skull base should be conceived as a single anatomic structure, it was to our convenience to group all those approaches that run from the antero-lateral, pure lateral and postero-lateral side of the skull base as “Surgery of the lateral skull base”. “50 years of endeavour” points to the great effort which has been made over the last decades, when more and more difficult surgeries were performed by reducing morbidity. The principle of lateral skull base surgery, “remove skull base bone to approach the base itself and the adjacent sites of the endo-esocranium”, was then combined with function preservation and with tailoring surgery to the pathology. The concept that histology dictates the extent of resection, balancing the intrinsic morbidity of each approach was the object of the first section of the present report. The main surgical approaches were described in the second section and were conceived not as a step-by-step description of technique, but as the highlighthening of the surgical principles. The third section was centered on open issues related to the tumor and its treatment. The topic of vestibular schwannoma was investigated with the current debate on observation, hearing preservation surgery, hearing rehabilitation, radiotherapy and the recent efforts to detect biological markers able to predict tumor growth. Jugular foramen paragangliomas were treated in the frame of radical or partial surgery, radiotherapy, partial “tailored” surgery and observation. Surgery on meningioma was debated from the point of view of the neurosurgeon and of the otologist. Endolymphatic sac tumors and malignant tumors of the external auditory canal were also treated, as well as chordomas, chondrosarcomas and petrous bone cholesteatomas. Finally, the fourth section focused on free-choice topics which were assigned to aknowledged experts. The aim of this work was attempting to report the state of the art of the lateral skull base surgery after 50 years of hard work and, above all, to raise questions on those issues which still need an answer, as to allow progress in knowledge through sharing of various experiences. At the end of the reading, if more doubts remain rather than certainties, the aim of this work will probably be achieved.

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Facial nerve management in jugular paraganglioma surgery: a literature review

Abstract: No strict guidelines for facial nerve management in jugular paraganglioma resection are available. Although long anterior rerouting provides the best tumour exposure along with a low morbidity rate, case-by-case selection of the surgical approach is recommended.

Cited by 17 publications

References 33 publications

Facial Nerve Paralysis after Onyx Embolization of a Jugular Paraganglioma: A Case Report with a Long-Term Follow Up

Facial Nerve Paralysis after Onyx Embolization of a Jugular Paraganglioma: A Case Report with a Long-Term Follow Up

Outcomes of Facial Nerve in Lateral and Inferior Mastoid Approaches for Jugular Foramen and Petrous Apex Lesions

Surgery of the lateral skull base: a 50-year endeavour

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